I live in WA state. I'm wondering if anyone knows or can point me to where the state says yes or no to homebirths being covered by state mandate?

My insurance coverage is through Aetna, unfortunately it's the HMO plan and so they've told me that homebirths are *not* covered. However, I went looking into the policy bulletins and it says this: However, applicable state mandates will take precedence with respect to fully insured plans and self-funded non-ERISA (e.g., government, school boards, church) plans. Unless otherwise specifically excluded, Federal mandates will apply to all plans.

I think that our plan is considered "fully insured", but don't really have a clue. It's the plan through dh's company.

I planned on having a hb with my last baby when dh's company switched to this plan and was immediately stripped of my midwife and thrust into an OB. I had to have a hospital birth and I think partially that produced my PPD (which thankfully I got over without meds). I want a hb with this baby, and since I have super quick l&d's (last baby was born in 45 minutes from the first contraction), we could construe the birth as an "emergency" which is what we've planned to do, but I'd like to find out the mandates in our state to see if it will be covered, rather than just going by what the ins. co. says.

So, if anyone can help me out, I'd appreciate it! :D TIA

Aetna is notorious for not covering homebirths. THey used to, but no longer. Sometimes, just asking if they cover a licensed midwife, but not mentioning homebirth makes a difference. For my clients, it hasn't. :(

You cannot force an insurance company to pay for homebirth, regardless of where you live. Each company can choose what they cover and what they do not.

I'd talk to some homebirth midwives in the area and find out their personal experience with Aetna.

Originally posted by pamamidwife

You cannot force an insurance company to pay for homebirth, regardless of where you live. Each company can choose what they cover and what they do not.


Not entirely true. I live in Florida, not usually noted for its progressive thinking, but thanks to an old redneck Governor who was a hb advocate, we have stellar laws on the subject.

If a company covers birth, they must cover midwifery. They cannot choose your provider for you. The only way they could avoid paying for a (licensed) midwife-attended hb is to alter their policy, refusing to cover any birth anywhere. Or they could just not sell insurance to Floridians.

Now, this doesn't prevent them from sending out a REALLY nasty legalese letter on the subject when you first get referred to a mw -- it essentially says "We think this is a foolish and dangerous idea, but we're forced to pay for it. If anything at all goes wrong, we will take every opportunity to screw your mw out of her fee."

Sadly, the old redneck has passed on and we're stuck with Jeb (spit, ptui!) so who knows how long it'll stay this way. Frankly, I'm surprised he hasn't gutted the law already. Must be an oversight.

Namaste,

Pallas

Wow, I had no idea. I haven't heard that WA state is that way (I'm close to there), but I guess it's not out of the realm of normal.

Kinda nice when homebirth is a bipartisan issue, isn't it? At least one good thing would come from having Jeb in office!